Substance use prevalence and the convergent validity of rating scales in a child and youth mental health service

Objectives: Although some decline in substance use among young Australians is evident, substance use disorder (SUD) continues to compromise mental health outcomes. The current study examined the prevalence of substance use problems and SUD among young people
attending a child and youth mental health service. The convergent validity of three routine clinical rating scales with a SUD diagnosis, and with each other, was also investigated. Method: Deidentified data from the Health of the Nation Outcome Scales for Children and
Adolescents (HoNOSCA), the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST), and the Clinical Risk Assessment and Management (CRAM) checklist were extracted from the clinical files of 90 young people attending the service. Results: Thirty-three percent of young people had a substance use problem and 14% met SUD criteria in addition to their mental health diagnosis. Iterative convergent validity analyses demon- strated HoNOSCA and CRAM substance use problem ratings aligned closely with a diagnosed SUD. ASSIST ratings differed significantly from HoNOSCA, CRAM, and a diagnosed SUD. Conclusions: The findings support the value of HoNOSCA in detecting substance use amongst young people presenting at a child and youth mental health service. ASSIST had lower completion rates suggesting lower clinical utility.